The new coronavirus (COVID-19) pandemic continues unabated. The UNO declared that the problem could reach “apocalyptic proportions”.1 At the time of writing this, the number of infected and dead on the planet exceeds 439,000 and 19,600, respectively. There are almost 7,000 deaths in Italy and 3,400 in Spain. Regarding the number of infections, the WHO pointed out the possibility for the new epicenter to be the United States, which has more than 55,000 infected and almost 200 deaths.
By: Daniel Sugasti
The dynamics reveal a dramatic picture, with unpredictable prospects in all areas. To get an idea, the last major epidemic outbreak in the world was Ebola, concentrated in West Africa. This highly infectious disease took two years to be “restrained” and caused approximately 11,000 deaths. That is less than COVID-19, which spread three or four months ago.
In severe cases, especially among people over sixty or with pre-existing conditions, COVID-19 causes serious pneumonia requiring urgent hospitalization in intensive care units (ICU), equipped with mechanical ventilators. Among the medical equipment considered basic, this equipment is decisive in dealing with respiratory failure caused by the coronavirus.
The lack of breathing machines in Italian hospitals, in the context of a health system that collapsed in the face of the demand generated by the pandemic, was a central element that led to medical teams having to decide who would or would not have the opportunity to survive. So much so that, in early March, an age limit was set for the admission or non-admission of serious patients to intensive care. Thousands were simply left to their own faith, and among other reasons, this explains the high mortality rate of the new coronavirus in the third economy of the Eurozone.
The Ventilators Business
As in any crisis of capitalism, the world bourgeoisie will try to make the cost be paid by the sweat and death of the proletariat and oppressed sectors. A section of the petit-bourgeoisie and urban middle sectors will certainly also suffer a heavy blow. There will even be factions of the property-owning class that will not get the rates of profit they aspire to. The crisis will increase the polarization, which predates the COVID-19 crisis because it will directly pose the problem of who loses and who wins; who survives and who dies.
That said, it is no less true that a section of the world bourgeoisie will make immense fortunes by speculating in the life and death of millions of human beings.
Not to mention the powerful pharmaceutical industry, led by American companies, which estimates to make a profit of one and a half billion dollars until 2023.2 For these tycoons, there is no crisis.
Due to its important relationship with the coronavirus crisis, we will approach here some aspects of the industry dedicated to the development of technologies and the production of complex medical equipment, such as artificial respirators.
Let’s start with a close example. In Argentina, the main local producer is TECME from Córdoba. The company announced -perhaps rubbing its hands- that it meets the conditions to cover a demand that grew “exponentially”, around 300%, with the coronavirus crisis. The ICU respirators have a market value of between $20,000 and 40,000 dollars, depending on the model. But the average is $25,000. This could provide an estimate of the profits this sector hopes to accumulate. According to Forbes magazine, the businessmen Paolo and his brother Gianfelice Rocca, owners of the Techint group, are the richest men in Argentina, with an estimated fortune of 4.1 billion dollars. If their assets were confiscated and, say, made available to deal with the pandemic, some 164,000 respirators could be purchased. How much could be done to save lives if those resources were made available to meet the urgent needs of the majority of society?
Let’s move on to examples of bigger fish. “As the pandemic spreads, there is an unprecedented demand for medical supplies, especially respirators,” said an executive from GE Healthcare, the health division of General Electric (GE). This is a full-blown multinational. Its factories are operating 24 hours a day. GE Healthcare was responsible for just over 16% of GE’s $121 billion turnovers in 2018. It can be assumed that those profits will grow at fastly from the spread of COVID-19. In this regard, the GE announced on March 24 an agreement with Ford and 3M to increase the production of respirators.3
Another company interested in taking advantage of the business is the Dutch company Philips, which between 2014 and 2018 operated a shift towards the medical equipment market. And it did not do badly: its profits increased by 169%, some 1.1 billion euros.4
The race to produce respirators also led the Swedish manufacturer Getinge and the French manufacturer Air Liquide to increase their assembly line. Dräger, the German medical technology giant, claims to have “doubled” its production. Löwenstein announced that it will guarantee a 6,500 units order placed by the German government, which will be paid for with public money. With a keen “nose for business”, the company had been increasing production since February, when the epidemic in China was at its worst and the global spread was almost a fact.
In the same vein, non-industrial companies are trying to relocate in the face of the pandemic crisis to increase their profits. The powerful automobile industry, which has much of its capacity idle, is struggling to reorient itself to the production of respirators and medical equipment.
It is the case, as we have said, of Ford, General Motors, Tesla, among others, which now have the “green light” from President Trump to manufacture respirators. In Europe, the French automaker PSA said it is studying “very seriously whether it is feasible” to enter this field. Germany’s Volkswagen and Daimler are also looking at options. While the businessmen take time to think, the German Ministry of Economy informed that such decisions can only be made by them: “the companies need to decide on their own”.5 On their side, in battered Italy, Ferrari and Fiat Chrysler Automobiles are talking to the largest local fan manufacturer about entering that market as well.
Other companies are considering the idea of designing new models and even 3D printing. The Dutch company Ultimaker, for example, offers such printing to produce ventilator valves.
Thus, while thousands of people die daily, a handful of tycoons speculate and profit from the pandemic. The capitalist states, with their governments, are fulfilling their role by offering them all kinds of stimuli, using public money.
The mechanical respirator business, which is only a part of the huge complex of multinational companies that control the production in the health field, shows and will continue to show that, until capitalism is liquidated, the profits of very few will be above the lives of millions.
There will be no intensive care beds or specialized personnel for all severe cases
Besides the respirators’ situation, each ICU bed needs trained personnel to handle them. A representative of the French National Union of Anaesthetists and Rescuers said that the COVID-19 resuscitation protocols require patients to be placed on their stomachs, and “five people are needed to do this”. These professionals, of course, require protective equipment such as masks, goggles, gloves, and disinfectants. These supplies, which are much cheaper than respirators, are in shortage in Europe.
The working class must be aware that as long as the production and supply of respirators and medical supplies essential to deal with the pandemic continue to be in the hands of the private sector, a general shortage is inevitable. For the poorer segments of our class, there will be almost complete lack.
This is because, in capitalism, health is not a human right but a commodity that can only be accessed by those who can pay for it. That is why, at times like this, ending this system of production is a matter of life and death.
In Brazil, South America’s largest economy, there were 106,800 hospital beds available in 2019, including “common” and ICU beds (approximately 60,000), most of them in the wealthier regions in the southeast of the country. According to David Uip – coordinator of the campaign against the coronavirus in the State of São Paulo, the most affected by the pandemic – 90% of these beds are occupied by cases not related to COVID-19. The government of São Paulo itself warns that the peak of infections will occur between April and May: 20% of the population could be infected; that is, 9,200,000 people. But behind the scenes, health authorities are not ruling out that the rate will reach 60%, some 27.2 million people.6
The Brazilian Association of Intensive Care Medicine warned that, in the epicenters of the pandemic, the average demand reached 2.4 ICU beds per 10,000 inhabitants. This represents almost double the average for the Brazilian public sector, on which 80% of the population depends.7 In any case, the conditions for a collapse are served: 60% of Brazilian municipalities do not have respirators in the public health network.8
The outlook gets worse when it is known that, in severe cases of COVID-19, the period of occupation of an ICU bed, with its respective artificial ventilator, can reach 20 days.
This macabre perspective should not be surprising since it is a direct result of decades of neoliberalism and the deliberate dismantling of the Brazilian public health system, the SUS. According to DataSus, in the last decade, there was a 5% reduction in beds.9 Researchers from Oxford University, in a preliminary study, estimated that Brazil could register 478,000 deaths.10 A report by ABIN, Brazil’s intelligence agency, forecasts more than 200,000 infected and 5,500 dead as of April 6, according to The Intercept.11 In the rest of Latin America, the situation should be no different.
According to projections from a Harvard study, between 40 and 70% of the population worldwide will be contaminated: this means between 3.1 and 5.5 billion people.12 Of the total number of people infected, it is predicted that 15% will require hospitalization and nearly 4% will die.
Europe is showing all the inability of imperialist capitalism to deal with the pandemic. In the U.S., a possible new epicenter, the working class, and its most impoverished sectors will pay the consequences of the absence of a public health system. U.S. hospitals have 62,000 mechanical ventilators available and could add another 99,000 that are considered obsolete and are in storage, according to the Society of Critical Care Medicine.13
If that is the reality in the imperialist countries, what can be expected in the peripheral capitalist countries?
According to the 2019 census conducted by the consulting firm Global Health Intelligence (GHI), the basic infrastructure of hospitals in almost all Latin American countries is completely deficient. If we take data on the availability of mechanical respirators, we find, among others, that Mexico has 16,739; Argentina has 5,777; Colombia has 6,293; Chile has 1,737; Bolivia has 750; Guatemala has 528; Panama has 488, and Costa Rica has 298 pieces of equipment. It is not difficult to note that these numbers will not account for a possible demand of 15% of patients from the risk groups defined by the characteristics of the COVID-19. In all cases, we insist, it is assumed that 80% of the beds and ventilators are already occupied for other reasons.14
The case of Haiti, the poorest nation in the Americas, is dire, and COVID-19 may prove to be uncontrollable. Two-thirds of its population survives in subhuman conditions, without food, drinking water or access to soap. Cholera is endemic and in its last outbreak left 10,000 dead. High rates of malnutrition, HIV infection and tuberculosis increase the number of immunosuppressed people. A report by the St. Luke’s Foundation and the Maryland Medical Center in 2018 warned that, with a population of over 10,000,000, only 90 beds were available for intensive care. Of these, only 45 had respiratory support.15
A Socialist Program to Face the COVID-19 Pandemic
There is no effective way out for the working class as long as health care is in the hands of the capitalist class. For the rich, who can be served in the best possible way, the lives of millions of workers do not matter. A Brazilian businessman, the owner of a network of restaurants, had an attack of sincerity a few days ago and stated that Brazil could not stop for “five or seven thousand deaths”.16 This is the logic of capitalists. The important thing is to continue producing, to profit. The rest does not matter, it will not go beyond “collateral damage”. The working class, for the rich, is cannon fodder. As we stated in another text, there is no middle ground: it is either them or us.17
The only realistic and coherent way out for the defense of the lives of millions is the expropriation, without compensation and under workers’ control, of the main levers of the world economy. Amid the pandemic, especially the pharmaceutical industrial complexes and those destined for the production of medical equipment, such as beds, respirators, masks, glasses, gloves, alcohol, and everything necessary to face the virus.
It is urgent to confiscate these industries currently in the hands of a handful of tycoons and put them to work based on a workers’ and socialist economic plan.
Heavy investment in scientific research is imperative, among many other measures. By freeing science and technological development from capitalist pettiness, it will be possible to move more quickly and effectively toward possible alternatives for immunization or new models of respirators that are cheaper and suitable for large-scale production.
In the same way, as we have pointed out in other publications, it is necessary to fight for measures that guarantee effective social isolation for the working class, without job losses or wage reductions.
Translation: Sofia Ballack.
Notes:
[1] See: <http://g1.globo.com/globo-news/globo-news-em-pauta/videos/t/todos-os-videos/v/onu-fala-em-pandemia-de-proporcoes-apocalipticas/8428454/>.
[2] See: <https://guiadafarmacia.com.br/estudo-iqvia-mercado-farmaceutico-global/>.
[3] See: < https://www1.folha.uol.com.br/colunas/painelsa/2020/03/ford-quer-elevar-producao-de-respiradores-com-3m-e-ge.shtml?origin=folha>.
[4] See: <https://exame.abril.com.br/negocios/para-a-philips-inovacao-medica-se-antecipa-a-regulamentacao/>.
[5] See: <https://oglobo.globo.com/economia/coronavirus-alemanha-pede-fabricantes-de-automoveis-que-produzam-equipamentos-medicos-1-24321252>.
[6] See: <https://brasil.elpais.com/politica/2020-03-22/coronavirus-no-brasil-segue-a-curva-de-paises-europeus-e-sao-paulo-preve-ate-9-milhoes-de-infectados.html>.
[7] See: <https://www.poder360.com.br/governo/sus-nao-tem-leitos-de-uti-para-enfrentar-coronavirus-diz-jornal/>.
[8] See: < https://saocarlos.clubefm.com.br/noticias/60-dos-municipios-brasileiros-nao-tem-respiradores-mecanicos>.
[9] See: <https://g1.globo.com/sp/sao-paulo/noticia/2020/03/21/queda-no-numero-de-leitos-e-pico-de-internacoes-por-doencas-respiratorias-em-abril-e-maio-sao-desafios-diante-de-coronavirus-em-sp.ghtml>.
[10] See: <https://theintercept.com/2020/03/16/coronavirus-estudo-mortos-bolsonaro/>.
[11] See: <https://theintercept.com/2020/03/24/coronavirus-abin-projeta-mortes/?fbclid=IwAR2YHpMk_etoJrgl-u4vhZud9oBR39Em7UF5G2istkK8Pu3-Gy5T9Uz0b4Q>.
[12] See: <https://www.businessinsider.com/coronavirus-outbreak-could-hit-3-billion-adults-harvard-expert-2020-3?r=US&IR=T>.
[13] See: < https://www.forbesargentina.com/como-planean-aumentar-su-produccion-los-fabricantes-de-respiradores/>.
[14] See: < https://interferencia.cl/articulos/exclusivo-asi-esta-preparada-america-latina-para-el-covid-19-en-cuanto-infraestructura>.
[15] See: <https://www.bbc.com/mundo/noticias-america-latina-51984658>.
[16] See: < https://istoe.com.br/dono-do-madero-diz-que-brasil-nao-pode-parar-por-5-ou-7-mil-mortes/>.
[17] See: <https://litci.org/en/covid-19-its-them-or-us/>